Booneville Chiropractic Clinic, P.a.

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

885 Issued in MS

Legal business name

BOONEVILLE CHIROPRACTIC CLINIC, P.A.

Practice address

105B N 2ND St
Booneville, MS 38829-3207

Phone

(662) 728-7414

Fax

(662) 728-4163

NPI assigned

Mar 27, 2012

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Derrick Roy Blythe, D.C.

Title

President

Phone

(662) 728-7414

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1332806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332806400000",
    "number": "1154697910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105B N 2ND ST",
            "city": "BOONEVILLE",
            "state": "MS",
            "postal_code": "388293207",
            "telephone_number": "662-728-7414",
            "fax_number": "662-728-4163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105B N 2ND ST",
            "city": "BOONEVILLE",
            "state": "MS",
            "postal_code": "388293207",
            "telephone_number": "662-728-7414",
            "fax_number": "662-728-4163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOONEVILLE CHIROPRACTIC CLINIC, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-27",
        "last_updated": "2012-03-27",
        "status": "A",
        "authorized_official_last_name": "BLYTHE",
        "authorized_official_first_name": "DERRICK",
        "authorized_official_middle_name": "ROY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "662-728-7414",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "MS",
            "license": "885",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Malerie Blakney
• Derrick Roy Blythe, D.C.
• Anna Bolton
• Booneville Anesthesia Services LLC
• Booneville Assisted Living LLC
• Booneville Community Pharmacy of Ms Inc.
• Booneville Community Pharmacy of Msinc (Booneville Community Pharmacy)
• Booneville Discount Drugs Inc
• Booneville General Dentistry, P.a.
• Booneville Internal Medicine PC

• Clinic/Center in Booneville, MS
• Providers in Booneville, MS by specialty
• Clinic/Center in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.